International Cooperative Study on the Relationship between Dietary Factors and Blood Pressure: a Preliminary Report from the Cardiovascular Diseases and Alimentary Comparison (Cardiac) Study
Restricted accessResearch articleFirst published online April, 1992
International Cooperative Study on the Relationship between Dietary Factors and Blood Pressure: a Preliminary Report from the Cardiovascular Diseases and Alimentary Comparison (Cardiac) Study
To investigate the epidemiological relationship of dietary factors to blood pressure (BP) and major cardiovascular diseases, we carried out the international cooperative Cardiovascular Diseases and Alimentary Comparison (CARDIAC) Study, which so far involves 48 centers in 20 countries as of August 1991. From each population, 100 men and 100 women aged 50–54 years were randomly selected for BP measurement, 24-h urine collection, blood tests, and medical interview. Various biological markers of diets from urine and blood were analyzed centrally in the Izumo CARDIAC center. Cross center analysis using simple linear regression revealed strong significant correlations of body mass index (BMI) to systolic BP (SBP; p 0.01) and diastolic BP(DBP; p 0.001) in men. 24-h urinary sodium (Na) excretion in men also showed significant correlations with SBP (p 0.05) and DBP p 0.05) even after controling for the effect of BMI (SBP; p 0.05, DBP; p 0.05). Within center analysis using multiple linear regression implied that BMI and Na strongly adversely affect BP, whereas magnesium may have beneficial influence on BP. Multicolinearities among 24h urinary sodium, calcium, and urea nitrogen were noted in men.
ElliotP., MarmotM., DyerA. (1989a) The INTERSALT Study: Main results, conclusions and some implications.Clin Exp Hypertens[A], A11, 319–28.
2.
ElliotP. ed., (1989b) The INTERSALT Study—an international cooperative study of electrolyte excretion and blood pressure: further results.J Human Hyper tens.3, 279–407.
3.
FukuokaM., YamoriY. (1987) A proposal for indirect and objective blood pressure measurement in adults. In: YamoriY., & LenfantC., eds. Prevention of cardiovascular diseases: An approach to active long life.127–32Elsevier, Amsterdam.
4.
HametP. (1991) Interactions among calcium, sodium, and alcohol intakes as determinants of blood pressure.Hypertension.17 (Suppl 1). 150–154.
5.
INTERSALT Cooperative Research Group. (1988) INTERSALT: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion.Br Med J.297, 319–28.
6.
Iso, H., Jacobs, D.R., Wentworth, D., Neaton, J.D. & Cohen, J.D., for the MRFIT research group. (1989) Serum cholesterol levels and six-year mortality from stroke in 350, 977 men for the multiple risk factor intervention trial.The New England Journal of Medicine.320, 904–910.
7.
JoffresM.R. (1987) Relationship of magnesium intake and other dietary factors to blood pressure: the Honolulu Heart Study.Am J Clin Nutr.45, 469–75.
8.
KestelootH., and GeboersJ. (1982) Calcium and blood pressure.Lancet, 1, 813–815.
9.
KobayashiJ. (1957) Geographical relation between the chemical nature of river water and death rate for apoplexy.Biol Okayama Univ, 11, 12–21.
10.
LaiS. (1989) Urinary electrolytes and blood pressure in three Yi farmer populations, China.Hypertension, 13, 22–30.
11.
LiuK., CooperR., McKeeverJ. (1979) Assessment of the association between habitual intake and high blood pressure: methodological problems.Am J Epidemiol, 110, 219–26.
McCarronD.A. (1982a) Dietary calcium in human hypertension.Science, 217, 267–269.
14.
McCarronD.A., HenryH.J., & MorrisC.D. (1982b) Human nutrition and blood pressure regulation: an integrated approach.Hypertention, 4 (supp III), III 2–13.
15.
McCarronD.A., MorrisC.D., HenryH.J., & StantonJ.S. (1984) Blood pressure and nutrient intake in the United States.Science, 224, 1392–98.
16.
McCollisterR.J. (1963) Urinary excretion of magnesium in man following the ingestion of ethanol.Am J Clin Nutr.12, 415–20.
17.
MtabajiJ.P., NaraY., MoriguchiY., & YamoriY. (1990a) Diet and hypertension in Tanzania.J Cardiovasc Pharmacol.16 (suppl. 8). S3–5.
18.
MtabajiJ.P., NaraY., & YamoriY. (1990b) The CARDIAC Study in Tanzania: Salt intake in the causation and treatment of hypertension.J Hum Hypertens.4, 80–81.
NaraY., ZhaoG.S., HuangZ.D. (1990) Relationship between dietary factors and blood pressure in China.J Cardiovasc Pharmacol.16 (suppl. 8). S40–42.
21.
SaitoK. (1989) Effects of oral calcium on blood pressure response in a salt-loaded borderline hypertensive patients.Hypertension.13, 219–226.
22.
StaessenJ. (1983) Four urinary cations and blood pressure, a population study in two Belgian towns.Am J Epidemiology.17, 676–687.
23.
YamoriY., LovenbergW., & FreisE.D., eds. (1979) Prophylactic approach to hypertensive diseases.Raven Press, New York.
24.
YamoriY., NaraY., KiharaY., ManoM., & HorieR. (1984) Simple method for sampling consecutive 24 hour urine for epidemiological and clinical studies.Clin Exp Hypertens, A6, 1161–7.
25.
YamoriY., & LenfantC., eds. (1987) Prevention of cardiovascular diseases: An approach to active long life.Elsevier, Amsterdam.
26.
YamoriY., & StrasserT. eds. (1989) New horizons in preventing cardiovascular diseases.Elsevier, Amsterdam.
27.
YamoriY., NaraY., KiharaY., ManoM., & HorieR. (1987) Urinary amino acids as biological indices for dietary protein intake. In Prevention of cardiovascular diseases: An approach to active long life.Elsevier, Amsterdam.
28.
YamoriY. (1989a) Predictive and preventive pathology of cardiovascular diseases.Acta Pathol Jpn, 39, 683–705.
29.
YamoriY., NaraY., HorieR. (1989b) Experimental and epidemiological studies on the relation of trace elements in the pathogenesis and prevention of cardiovascular diseases. In: TomitaH. ed. Trace elements in clinical medicine.65–75Springer-Verlag, Tokyo.
30.
YamoriY., NaraY., MizushimaS., ManoM., SawamuraM., KiharaM., & HorieR. (1990) International cooperative study on the relationship between dietary factors and blood pressure: A report from the Cardiovascular Diseases and Alimentary Comparison (CARDIAC) study.J Cardiovasc Pharmacol.16 (suppl. 8). S43–47.
31.
World Health Organization study group. (1982) Prevention of coronary heart disease. World Health Organization Technical Report Series. 678. Geneva.
32.
World Health Organization study group. (1983) Primary prevention of essential hypertension. World Health Organization Technical Report Series. 686. Geneva.
33.
World Health Organization Regional Office for Europe. (1984) Estimation of sodium intake and output: review of methods and recommendations for epidemiological studies: Report on a WHO meeting by WHO Collaborating Center for Research and training in Cardiovascular Diseases, Gothenburg, Sweden, and World Health Organization. Gothenburg/Geneva.
34.
World Health Organization Collaborating Center on Primary Prevention of Cardiovascular Diseases, and Cardiovascular Unit, World Health Organization. (1986) CARDIAC Study protocol. Izumo/Geneva.
35.
World Health Organization study group. (1990) Diet, nutrition, and the prevention of chronic diseases. World Health Organization Technical Report Series. 797. Geneva.
36.
ZemelM.B. (1986) Sodium excretion and plasma renin activity in normotensive and hypertensive black adults as affected by dietary calcium and sodium.J hyper tens.5 (Suppl 6). s343–s345.
